Guy Talk

The good news about testicular cancer is that it’s a relatively rare disease with impressively high cure rates when caught early. The downside is that males most often afflicted by it—teens and young men between fifteen and thirty-four—don’t always have the disease on their personal health radar. “It can be challenging at times because you are not talking to a demographic that is particularly worried about cancer,” says Dr. Craig Tifford, a Stamford resident and orthopedic surgeon who is a sixteen-year survivor of testicular cancer diagnosed at stage four. “Since there’s no blood test and no imaging test for this, my mantra is self-exam. It’s the only way to catch it early.”

Indeed, urologists who diagnose testicular cancer stress the importance of regular self-exam as the most proactive way to catch it when it’s most treatable.

Dr. James Rosoff, a urologist affiliated with Greenwich Hospital, and an assistant professor of urology at the Yale School of Medicine, says testicular cancer usually presents with a small, painless lump, about the size of a dime, that is palpable when touched by hand. “Just checking once a month in the shower and you should be able to tell if something is not normal,” he says.

Dr. Scott Serels, chief of urology at Norwalk Hospital, notes that the importance of self-exam probably isn’t being discussed enough because in 2004, the U.S. Preventive Services Task Force, an independent panel of primary care experts, recommended against routine testicular cancer screening. (It reaffirmed that decision in 2009.) “Their thinking was because it’s so rare, screening is actually creating unnecessary anxiety,” he says. “As urologists, we…have a different perspective. There’s screening for breast and colon cancer, which can and does save lives. We know if you encourage men and boys and their doctors to check for this, you can stop the disease in its path and that can improve outcomes.”

WHAT ELSE YOU NEED TO KNOW

1 KEEP UP SELF-EXAMS
While urologists recommend regular self-exams should begin in teens as young as fifteen, it’s important for men to keep the habit up for a lifetime. “Even though you tend to see this in younger men, I’ve diagnosed testicular cancer in men in their fifties,” says Dr. Rosoff.

2 TALK TO THE PEDIATRICIAN
Parents should not assume their pediatrician is covering the finer points of self-examination with their teenage sons. “There’s a lot to cover in a teenager’s well visit,” says Dr. Rosoff. “Talk to your pediatrician [and] let them know you would like that [talk] to happen.”

3 KNOW YOUR RISK FACTORS
Boys born with undescended testicles have a higher risk of developing testicular cancer. Since undescended testicles are often repaired when boys are babies, Dr. Serels says, some men are unaware of this risk factor. So, it’s important for parents to share this background—and any family history—with their sons. “It’s also something your doctor should know,” he adds.

4 TREATMENT OPTIONS
Caught early, testicular cancer has cure rates in excess of 90 percent, and responds well to a regimen that includes chemotherapy and radiation, says Dr. Serels. Surgical removal of the testicle is required and men opt for a prosthetic replacement. “I’ve found that whether they decide on a prosthetic tends to depend on age,” he says. “Younger patients tend to go in this direction because they are more self-conscious.”

5 WHAT ABOUT FERTILITY?
Dr. Rosoff says normal fertility usually returns in about two years for men treated for testicular cancer. Some men opt to bank sperm if their regimen includes chemotherapy.